Blood circulation



June 25, 1957 F. A. SMITH ,796,861

' Q 31.000 cmcuurrxou Filed Dec. 23, 1952 5 Sheets-Sheet 1 FIG. I

. IN V EN TOR.

FREDRICK A. SMITH BY {5% (P 46.4

ATTORNEY June 25, 1957 F. A. SMITH 2,796,861

BLOOD CIRCULATION Filed Dec. 23, 1952 3 Sheets-Sheet 2 IN V EN TOR. FREDERICK A. surr'n L. La M ATTORNEY June 25, 1957 F. A. SMITH 2,796,861

BLOOD CIRCULATION F iled Dec. 23 1952 3 Sheets-Sheet 3 I I i 27 I I I 29 I 1 I I ii! 1 I a! I III I IJ' E15 II 1' i 1 I I I 'l l 1 I l l I l l i l I I I I i I I I 1 I I I 3 l 32 I l l i 24 i 28 l I l I I g I \g M INVENTOR.

FREDERICK A. SMITH ATTORNEY United States Patent BLOOD CIRCULATION Frederick A. Smith, Akron, Ohio Application December 23, 1952, Serial No. 327,542

12 Ciaims. (Cl. 128-44) This invention relates to improving the circulation of blood in the limbs of a human. It includes the method of improving the circulation and means for accomplishing the same.

More particularly the invention relates to lifting the outer extremity of a persons leg or arm, suitably supported, so that the blood drains toward the heart, then rapidly lowering it to force the blood into the leg or arm by centrifugal force, and repeating this operation at frequent intervals. It may be desirable to have the patient breathe oxygen-enriched air during this treatment to insure an adequate supply of oxygen in the blood.

This treatment is desirable in those pathological states characterized by diminished flow or obstruction of the flow of arterial blood through the arteries and capillaries. The most common of these are: arteriosclerosis of the peripheral arteries, gangrene (both diabetic and arteriosclerotic), ulcers of long standing where the circulation has become impaired, intermittent claudication, neurogenic lesions wherein the trophic nerves or the motor nerves, or both, have been suddenly interfered with or cut off (.i. e. in poliomyelitis), frostbite, and certain skin lesions.

The invention will be further described in connection with the accompanying drawings, in which- Fig. 1 is an elevation of a person sitting with one foot in a cast which is attached to and is a part of the circulation-improving means;

Fig. 2 is a plan view on the line 2-2 of Fig. 1;

Fig. 3 is a section on the line 33 through the cast shown on the person in Fig. 1;

Fig. 4 is an end view on the line 4-4 of Fig. l; and

Fig. 5 is an elevation partly broken away of the cast support.

Figure 1 shows the person 1 seated in a reclining position on the seat 2 and reclining against the back support 3. The inclination of this back support may be adjusted by adjusting the angle of the brace 4.

The left leg 5 of the person is preferably supported in a somewhat elevated position as by resting on the cushion 6. The right leg 7 covered by the sponge rubber cushions 8 (Fig. 3) is supported in the cast 9 which is held in position on the leg by the coarsely woven and somewhat elastic bandage 10, commonly called an Ace bandage. Figure 1 shows the right leg '7 in the lowered position in full lines, and in the raised position in broken lines. The arrows indicate that the foot is lifted from the lowered position shown in full lines to the raised position shown in broken lines.

The apparatus includes the base 11 which is mounted on casters 12 so that it can be moved easily about the room. For instance, it may be rolled under the bench ,13 after the person 1 has seated himself, as shown in the drawing. After use it can be rolled out from under the bench before the person alights. The motor 15 and gearreduction box 16 are mounted on the base.

Also mounted 'on the base is a framework which includes the spaced parallel horizontal angles 18 at one 2,796,861 Patented June 25, 1957 ice end of which the uprights 19 are permanently fastened and braced by the angles 20. These uprights are generally not more than four or five feet high. This framework is rigid and tightly fastened to the base by any suitable means. It will be noted that the motor and gear box are mounted at the end of the base away from the uprights 19 and this gives better weight distribution than if the motor and gear box were mounted nearer the upright.

Fastened between the horizontal angles 18 .is the bearing 23 (Fig. 2). .Pivotally mounted on this hearing is the hoist arm .formed of the two spaced members 24'which are preferably made of metal. They are separated by spacers 25. This ihoist arm 24 is parallel with the angles 18 and is adapted to lie on the base 10 between these angles with one end near the base of the uprights 19. The cord, chain or wire or the like :27 is fastened to the pin 28 at the outer end of the hoist arm. It is looped over the pulley 29 at the top of the frame, and the weight 30 keeps it in place when not in use.

In order 'to prevent the localization of pressure at any place on the surface of the leg 7 which might interfere with restoring normal circulation, the leg 7 is held in the cushioned support which has been described. This support is formed by first wrapping the leg with ordinary sheet wadding and stockine'tte (not shown), of the type ordinarily used in making a plaster cast, however, more of the wadding is used than ordinarily because when the top of the cast is removed this sheet wadding .and stockinette are removed from the cast and replaced by sponge rubber 8 which is made to fit the cast exactly. This forms the cushion in which the leg rests. The wadding is substantially the thickness of the uncompressed sponge rubber. The metal reinforcing member 31 is incorporated in the cast and not only serves to reinforce the cast, but the lower end is provided with a hook 3.2 which is engaged by the loop 33 at the endof the rope 27. Any suitable means for attaching the cast to the rope may be employed. The reinforcing element 31 advantageous'ly extends from near-the top of thecast to the toes.

The support for the leg may be made in other ways. However it is made, it is important that there be no localization of pressure on the leg which would interfere with the restoration of circulation.

When not in use the hoist arm 24lies on the base 10 and pulls the weight 30 near the top of the upright. When in use the weight of the patients foot tends to lower the weight 30 and raisethe'hoist arm 24 to'the position shown in full lines in Fig. 1. When the patient has .been comfortably seated and the cast has been put'in place .and the rope 27 attached, the motor '15 is started. The switch for the motor may be on a cord placed at the patients side so that the patient can operate the motor himself, or the switch may be located for the use of an attendant.

The motor, through the gear box 16, drives the belt 40 which in turn rotates the pulley 41. This pulley operates at a uniform speed. The pulley is supported on the shaft 42 which in turn is supported by the uprights 43. At the center of the shaft is .the cam 45. The leading edge 46 of the cam is shaped to contact the follower 47 between the bars 24 of the hoist arm. The cam presses the follower 'down and this lowers the hoist arm, raising the right leg 7 of the person undergoing treatment. In the starting position the leading edge .46 of the cam contacts the follower at a location near the center of the cam. From this pointit travels substanially in a circle to a point from which the leading edge gradually recedes from the center to the point '49 which is the point of the cam farthest from the center. As the cam is'rotated in'the direction shown "by the arrow,

} the leading edge 46 presses onthe'followerlowering the hoist arm and raising the patients leg until the point 49 of the cam reaches the follower. The leg is then in the raised position shown in broken lines. From the point 49 the surface of the cam 50 is substantially a radius. This allows the leg 6 to drop precipitiously, raising the hoist arm with it, until the leg and hoist arm, etc. assume the position shown in full lines in Fig. 1. The drop of the leg can be cushioned somewhat either by placing a cushion under the hoist arm or by the design of the cam. Thus, the inner end of the surface 50 can be rounded more or less gradually to break the drop. The purpose of dropping the leg is to improve the circulation by centrifugal force, and it is therefore important that the drop should not be cushioned too much.

The shape and speed of operation of the cam will determine the nature of the treatment. The machine now in use makes two revolutions per minute and is so shaped as to require twenty seconds to lift the foot from the drop position. Raising the foot slowly through a period of twenty seconds gives ample time for the drainage of the used blood back into the general circulation. The cam is so cut that at the end of that twenty-second period just described the foot falls very suddenly and remains in the dropped position for ten seconds, allowing time for a fresh supply of blood to be gathered into the extremity.

This procedure gives two such cycles per minute. The purpose of the sudden fall is to employ centrifugal force which throws the blood from the upper part of the limb down into the foot.

When circulation is poor, the supply of oxygen to the affected area is deficient. To overcome this deficiency, it will ordinarily be desirable to supply the patient with oxygen-enriched air. The extra oxygen may be mixed with the air and fed from a supply tank 60 or the like through the tube 61 into the mask 62. The mask illustrated is of the type provided with a flapper valve (not shown) through which the used air is exhausted. It is not essential to thus increase the supply of oxygen in the blood stream, but it will be desirable in the treatment of cases in which there has been impairment of normal circulation for a sufiicient period of time to produce a serious situation.

Assume, for example, that the right leg of a person has developed gangrene, due, for example, to a diabetic condition. Satisfactory treatment was given in such a situation, by driving the cam through two cycles each minute, taking twenty seconds to raise the leg and allowing it to rest substantially ten seconds after each drop. The foot which was cold and badly gangrenous, warmed up in about thirty minutes. and some oxygen was fed to him in order to increase the amount of available oxygen in his blood. The usualamount of oxygen administered to a patient during this treatment is from two to five liters per minute, as measured by the standard gauge furnished. with the oxygen tank. The treatment was continued fifteen to forty-five minutes and repeated four to five times each day. The

average time per treatment was thirty minutes (sixty complete cycles per average treatment).

Although the invention has been described more particularly as applied to the treatment of a leg, and apparatus therefor, it is also applicable to ones arm. A modification of the equipment will be required for arm treatment. The arm can be dropped through an arc of 180', or any part thereof. The original cast may be formed to fit the whole arm up to the shoulder, and then the outer half may be cut away and the balance suitably cushioned with sponge rubber or the like. Repeated dropping from a height at which the blood drains to the body, through a wide arc improves the blood circulation.

What I claim is:

1. Apparatus for physiotherapy which includes a hoist arm pivotally mounted at one end so that the other end is free to move up and down, a support several feet above the floor, a rope-like member attached to said other end The patient wore a mask- Cir 4 of the hoist arm and carried upward over said support and down on the opposite side thereof, and means connected with the hoist arm and adapted to repeatedly (1) force the hoist arm downward when a downward pull is exerted on said rope-like member on said opposite side of the support and (2) release said hoist arm and permit said downward pull on the rope-like member to raise it.

2. The apparatus of claim 1 in which a cushion support for a human limb is attached to the rope-like member on said opposite side of the support and exerts a downward pull thereon when the limb is resting in the cushion support.

3. The apparatus of claim 1 in which the means to repeatedly force the hoist arm down and then release it is a generally circular cam the leading edge of which gradually winds outward from the center and then abruptly returns toward the center.

4. Apparatus for physiotherapy which includes a base supported on casters, a hoist arm pivotally mounted near one end to the base, an upright rising from the base near the other end of the hoist arm, toward the top of the upright a pulley on a horizontal axis, a cast for a human leg and foot, a rope-like member over the pulley with one end fastened to the foot of the cast and the other end fastened to the hoist arm near the base of the upright, a cam on a horizontal axis above the hoist arm and away from the pivotal mounting thereof, a follower on the hoist arm against which the cam operates, and

i means on the base for rotating the cam, the leading edge of the cam widening gradually from a first point near its axis to a point at which it abruptly returns to a third point which is also near its axis, the leading edge of the cam being substantially circular between said first and third points.

5. The process of treating the limb of a living animal in which the circulatory system is diseased but through which the blood can be forced which process comprises repeatedly, at frequent intervals, applying an external lifting force to the limb thereby raising it so that blood drains therefrom toward the animals body, and then by a force at least as great as gravity returning it to its unraised position and thereby forcing blood from the body into the limb by centrifugal force. a

6. Carrying out the process of claim 5 while the animal is breathing oxygen-enriched air.

7. The process of treating the limb of a living human being in which limb the circulatory system is diseased but through which the blood can be forced which process comprises repeatedly, at frequent intervals, applying an external lifting force to the limb thereby raising it so that blood drains therefrom toward the persons body, and then allowing gravity to return it to its unraised position and thereby force blood from the body into the limb by centrifugal force.

8. Carrying out the process of claim 7 while the person is breathing oxygen-enriched air.

9. The process of treating the limb of a living human being in which the circulatory system is diseased but through which the blood can be forced which process comprises supporting a large area of the limb in a cushion whereby there is no localized supporting pressure on the limb, and then repeatedly, at frequent intervals, lifting the cushion so as to cause the blood to flow towards the persons body and then quickly lowering it and thereby generating centrifugal force which causes the blood to flow outward in the limb.

l0. Carrying out the process of claim 9 while the person is breathing oxygen-enriched air.

11. The process of treating a leg and foot of a human being in which the circulatory system is diseased but through which the blood can be forced, which process comprises supporting a large area of the leg and foot in a cushion whereby there is no localized supporting pressure on either, and then repeatedly, at frequent intervals, lifting the cushion and thereby causing the blood'to drain toward the persons body, and then quickly lowering it by gravity and thereby generating centrifugal force which causes the blood to flow outward through the leg and foot.

12. Carrying out the process of claim 11 while the person is breathing oxygen-enriched air.

References Cited in the file of this patent UNITED STATES PATENTS 2,583,895 Siebrandt Ian. 29, 1952 Mercks Manual, 8th edition, 1950, published by Merck & Co., Inc., Rahway, N. 1., page 206. 

